New report shows improvements in mental health care for veterans at Togus

A report released Thursday by a federal watchdog stated the VA Maine Healthcare Systems-Togus has made significant improvements in the way it provides mental health care for veterans after following recommendations stemming from a 2015 report that found systemwide problems in providing service to veterans.

A 2015 report stated that the Office of the Inspector General in the U.S. Department of Veterans Affairs found problems with scheduling, staffing and employee morale in the mental health unit of the veterans system based in Togus, which serves nearly 10,000 patients who get treatment statewide for problems such as post-traumatic stress disorder and depression.

Dr. William Curtis, left, and Dr. Cameron McKee speak July 11, 2016, on the surgical floor of VA Maine Healthcare Systems-Togus during a tour of the veterans hospital, which has made significant improvements in mental health care, according to a new federal report. Staff file photo by Andy Molloy

The new report said the VA Maine system already had addressed sufficiently five of the eight recommendations made in the 2015 report, including implementing corrective actions to improve consult review and closure processes, according to a joint news release from Maine’s congressional delegation.

“We are pleased to see improvement since the last time the Inspector General reviewed the Maine VA’s health care practices, and we look forward to working with VA leadership in Maine to address the additional deficiencies identified by the Inspector General,” said U.S. Sens. Susan Collins and Angus King and U.S. Reps. Chellie Pingree and Bruce Poliquin in a joint statement. “It’s vitally important that no Maine veterans slip through the cracks when it comes to mental health.”

The report identified remaining problems related to scheduler training and scheduling appointments by sending a letter without making direct contact with a patient, which is against federal policy and can result in missed appointments.

The inspector general recommended the system director ensure mental health schedulers consistently make direct contact with patients prior to scheduling appointments, ensure schedulers prioritize the needs and well-being of veterans when scheduling appointments and ensure training and competencies are documented, complete and up-to-date for all staff members responsible for scheduling mental health appointments.

VA Maine Director Ryan Lilly stated in the report that the Facility Access Committee will develop and implement ongoing audits to confirm that appointments are indeed negotiated and direct contact is being made with veterans before scheduling appointments.

He also stated that the Facility Access Committee will review the current competency process for all schedulers and make recommendations for consistency across Maine VA properties, and a standardized competency form for schedulers will be developed and used annually for all staff members who schedule appointments.

The agency’s 2015 report linked Togus to nationwide systemic problems that sparked a scandal in 2014 that led to the resignation of VA Secretary Eric Shinseki. In some cases, Togus patients were not getting appointments or had to endure long wait times attributed to low staffing levels and employee turnover.

Togus employees also were closing appointments, the report said, before the patient received any care. It also stated some higher-ups directed employees sometimes not to log referrals in their computerized system, making it difficult to track whether patients had “unmet needs.”

Lilly, in a statement from 2015, said “mistakes that may have been made were generally a byproduct of either an outdated scheduling system or a lack of understanding” of administrative rules and said that some scheduling problems have been fixed.

In an interview with the Kennebec Journal in January, Lilly said he was working hard to increase employee engagement, meaning making sure all staff members are fully invested in the mission and are working at the top of their capacity.

“There’s a lot of great work happening here and across the state,” he said. “One of the challenges as you make improvements is making sure all employees are part of that process and strategy.”

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